期刊
FRONTIERS IN ONCOLOGY
卷 11, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fonc.2021.724467
关键词
nasopharynx cancer (NPC); neutrophil-to-lymphocyte ratio (NLR); neoplasm staging; concurrent chemoradiotherapy (CCRT); adjuvant chemotherapy
类别
资金
- National Natural Science Foundation of China [81760544]
- Key R&D Program of Guangxi [AB18221007]
- Project of Guangxi Medical and Health Appropriate Technology Development and Extension Application [S2018001]
- Guangxi Natural Science Foundation [2020GXNSFBA159002]
- Health Commission of Guangxi Zhuang Autonomous Region
Integrating NLR into the 8th edition of the AJCC staging system could improve the separation and discriminatory abilities for N classifications, but not for T categories. Patients in the RPA 4 group could benefit significantly from the addition of adjuvant chemotherapy to concurrent chemoradiotherapy.
ObjectiveThe present study aimed to evaluate the role of integrating the pretreatment neutrophil-to-lymphocyte ratio (NLR) into the eighth edition of the AJCC staging system for nasopharynx cancer in an endemic region. MethodsBetween May 2007 and December 2012, a total of 713 cases with NPC were retrospectively analyzed. The separation ability in terms of overall survival (OS), local failure-free survival (LFFS), distant metastasis-free survival (DMFS), and failure-free survival (FFS) was evaluated. The discriminatory ability was assessed using Harrell's concordance index (c-index). Recursive partitioning analysis (RPA) was conducted and incorporated with pretreatment NLR. ResultsWhen integrated with NLR, the separate and discriminatory abilities for N classifications were improved in terms of OS and DMFS, but not for T categories. By using Recursive partitioning analysis, five subgroups were generated. Compared with the overall stage, the integration of NLR could not enhance the separate and discriminatory abilities. However, patients in the RPA 4 group gained significant benefits in terms of OS (HR 0.390 (95%CI 0.212-0.716), P = 0.002) and FFS (HR 0.548 (95%CI 0.314-0.958), P = 0.032) from the additional adjuvant chemotherapy after concurrent chemoradiotherapy. ConclusionThe integration of NLR into the 8(th) edition of the AJCC staging system could enhance the separation and discriminatory abilities for N classifications, but not for T categories. In addition, patients in the RPA 4 group could benefit from the addition of adjuvant chemotherapy to concurrent chemoradiotherapy.
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